“You don’t have to be great to start, but you have to start
to be great!” Zig Ziglar

Reported in Healio, among
patients with rheumatoid arthritis, a significant proportion of those who
underwent a treatment-as-needed regimen with rituximab were found to have
delayed need for retreatment and disease flare, according to study findings.

The observational study
included medical records data for 151 patients with rheumatoid arthritis (RA)
who were treated with rituximab and
followed up for at least 12 months after the
onset of treatment. Most patients were concurrently taking a disease-modifying
anti-rheumatic drug (DMARD). Median disease duration was 15 years. The study was
published in the Journal of Clinical Rheumatology.

Comment: The decision when
to give Rituxan is complicated.Most
rheumatologists go with a six month schedule.This “treatment as needed” schedule is very appealing.

Mighty mouse breakthrough… next

Bone stem cells shown to regenerate bones and cartilage in adult mice

Reported in Science Codex, a stem cell capable of regenerating both bone and
cartilage has been identified in bone marrow of mice. The discovery by
researchers at Columbia University Medical Center (CUMC) was published in the
journal Cell.

The cells, called osteochondroreticular (OCR) stem cells, were discovered by
tracking a protein expressed by the cells. Using this marker, the researchers
found that OCR cells
self-renew and generate key bone and cartilage cells,
including osteoblasts and chondrocytes. Researchers also showed that OCR stem
cells, when transplanted to a fracture site, contribute to bone repair.

"We are now trying to figure out whether we can persuade these cells to
specifically regenerate after injury. If you make a fracture in the mouse, these
cells will come alive again, generate both bone and cartilage in the mouse--and
repair the fracture. The question is, could this happen in humans," says
Siddhartha Mukherjee, MD, PhD, assistant professor of
medicine at CUMC and a senior author of the study.

Nancy Walsh writing for MedPage Today reported patients with early
rheumatoid arthritis receiving "triple therapy" with conventional
disease-modifying anti-rheumatic drugs (DMARDs) were less likely to respond
inadequately when given supplementary fish oil, Australian researchers found.
After a year of treatment, 10.5% of patients receiving fish oil were considered
treatment failures, compared with 32.1% of those not receiving the supplement,
according to Susanna M. Proudman, MD, of the University of Adelaide, and
colleagues.

Comment: I’m not a real fan of triple therapy.That’s using a combination of methotrexate, Plaquenil, and sulfasalazine.I think biologics work much better and have fewer potential side effects.
Fish oil helps with RA regardless of what you take.

Popular Nerve Pain Medicine Has Little Effect On Back Pain.

Sonja Elmquist writing
in Bloomberg News reported that Pfizer Inc.’s best-selling drug, Lyrica (pregabalin),
“didn’t help patients with the most common cause of back pain,” severe lumbar
spinal stenosis, “any more than a placebo in a small study.” The study’s
findings, published in the journal Neurology, casts “doubt on the potential for
doctors to expand the medication’s use.” The FDA “has not approved the drug’s
use for spinal stenosis,” but Lyrica “and similar medicines are often used to
treat lower back pain.”

Comment: I don’t use
Lyrica for back pain.It is helpful
for peripheral neuropathy and shingles pain though.

A predictor for treatment success in
rheumatoid arthritis… next.

As Needed Rituxan for RA

Diana Swift writingin MedPage Today reportedin
early rheumatoid arthritis (RA) the most important single predictor of achieving
an absolute or a relative patient-perceived pain improvement (PPSI) after 6
months of treatment is baseline symmetrical arthritis, according to a Dutch
study published online in the journal Rheumatology.

Comment: I’ve actually
noticed the same phenomenon in my practice.

Another complication of
severe psoriasis… next

Psoriasis
severity linked to hypertension

Whitney McKnight
writing in Rheumatology News reported on findings from a University of
Pennsylvania study.In it
investigators found that the more severe a case of psoriasis, the greater the
likelihood of uncontrolled hypertension.The study was published in JAMA Dermatology.

Comment: Patients with
moderate to severe psoriasis should have blood pressure monitored closely.

Toy boat toy boat toy
boat… next

Study finds spike in toy-related injuries.

Muir reporting in ABC
World Newsstated that a study published in the journal Clinical Pediatrics has
found “a spike in toy-related injuries, up 40 percent in the last 24 years,”
with one US child having to go to the emergency department “every three
minutes.”

Comment: When I was a
kid,
one Christmas, my parents got my brother and I a Cape Canaveral rocket set
with spring loaded missiles.We had
a ball chasing each other around and shooting them at each other.

Yoga makes
you smarter

Reported in the Daily
Burst, in a recent eight-week study, adults over age 55 who took an hour-
long
class of hatha yoga (the most commonly practiced form of yoga worldwide) three
times a week had significantly better memory and attention than adults who
simply did stretching and toning exercises.

Neha Gothe, PhD, assistant
professor of kinesiology, Wayne State University, Detroit and colleagues
asserted, “. “The focus required to hold poses and control breathing during yoga
may result in better attention to mental tasks as well.”

Comment: I take
yoga.I’m not sure I’m smarter
because of it but it definitely makes me feel
better.

Are you feeling sluggish? ~ Do you have trouble finding energy
just to do everyday tasks? ~ Do you wish you had just a little more energy to
accomplish more in your day?

Wait no longer!We might have an answer, and it
really might just come in a pill!

“Natural Arthritis Energy Boost”

Add this natural energy to your day, and achieve more!

Whether your fatigue is due to daily stress or the health of your adrenal
glands, our powerful, advanced formula can help by delivering these
energizing benefits:

Boosts stamina,

energy and vitality

Promotes endurance and positive mood

Works to combat exhaustion due to adrenal gland
health

Eases feelings of being overwhelmed

Helps fight stress

Promotes healthy adrenal hormones

Fosters healthy immune system function·

Lifts that "run-down" feeling

Contributes to the metabolism of carbohydrates and
fatty acids

Enhances quality of life and well being

Plus… no energy crash like you may experience with other energy boosts!

Now instead of dragging your yourself
through the day, you can keep going strong from sun up to sun down with
Arthritis Natural Energy Boost. Unlike other formulas, this breakthrough
actually works at the cellular level to deliver more energy to your very
"core." You’ll feel alive and full of vitality whatever comes your way!!

Combine oats, cottage cheese, eggs, and vanilla in a blender or food
processor. Process until smooth. Gently stir in blueberries.

Heat a large nonstick skillet over medium heat. Coat pan with cooking
spray. Spoon about
2 tablespoons batter per pancake into pan. Cook 3 minutes
or until tops are covered with bubbles and edges look cooked. Carefully turn
pancakes over, and cook 3 minutes until golden.

Combine yogurt and maple syrup; serve over pancakes.

12 Unexpected Benefits of Pineapple You Need To Know

Food and Drink Lifestyle by Allison Renner

Pineapple is that delicious fruit, great for salads, drinks, or just by
itself – pineapple is still a delicious fruit. But did you know that it has many
unexpected benefits?

It’s packed with vitamins and minerals. Check out the
goods on pineapples: they’re loaded with vitamin A, vitamin C, calcium,
potassium, and phosphorus. While it’s rich in fiber and calories, it’s low
in fat and cholesterol. Pineapples are a great, nutritious fruit to add to
your diet to improve and maintain your health.

It strengthens bones. Pineapple contains manganese, a
mineral necessary for your body to build strong bones and connective
tissues. One cup of pineapple gives your body 73 percent
of the manganese it
needs!

It improves digestion. Bromelain is an extract found in
pineapple stems, and works to neutralize fluids to make sure they’re not too
acidic. Bromelain also regulates the pancreatic secretions that aid
digestion. You can keep your digestive tract healthy because it is high in
protein-digesting properties.

It keeps gums healthy. You brush your teeth several
times a day, but do you pay attention to your gums? Because pineapple has
such a high vitamin C content, eating the fruit lowers your risk of
gingivitis and periodontal disease. The more vitamin C in your diet improves
your body’s ability to fight invading bacteria that contributes to these
diseases.

It alleviates arthritis. Pineapple has
anti-inflammatory qualities, so including the fruit in your diet can
alleviate the pain of arthritis, along with similar conditions, like gout
and carpal tunnel syndrome. It also can help improve the condition overall
by strengthening your bones.

It prevents hypertension. If you’re trying to ease your
high blood pressure, or want to avoid getting it, then eat a lot of
pineapple. Because pineapples have a high amount of potassium and a low
amount of sodium, your body will maintain normal blood pressure levels.

It has anti-cancer properties. There might not be a
cure for cancer, but there are things that can help you prevent it, and
pineapple is one of those things. Because pineapples are so full of
antioxidants, they help fight against free radicals.

It prevents coughs and colds. The pineapple is rich in
vitamin C, which means it naturally boosts your immune system. This helps
you fight off coughs and colds.

It lowers risk of macular degeneration. Macular degeneration is
caused by
damage to the retina, and is the primary cause of vision loss in
adults. If you add pineapple in your regular diet, you can lower your risk
for this disease by up to 36 percent! This is because pineapple is full of
beta carotene, which is good for your sight.

It stays fresher longer. After bringing your pineapple
home from the store, you can keep it on the counter at room temperature for
a day or two before cutting. If you’re not ready to eat the pineapple after
two days, wrap it in plastic and it will stay good in the refrigerator for
three to five more days. Once you cut up the pineapple keep it in an
airtight container in the fridge and it will stay good—and nutritious!—for
six to nine days!

It’s a good weight loss food. Pineapple has a
delicious, natural sweetness that makes it taste like a dessert on its own.
As an added bonus, pineapple is low in calories, sodium,
cholesterol, and
saturated fats, while being a good source of fiber. This makes it the
perfect weight loss food because it’s a healthy, filling, and tasty snack!

It relieves nausea. A key benefit from pineapple juice
intake is that it averts nausea or morning sickness. This is quite useful
for pregnant women who usually experience nausea. It also helps people who
are looking to go on airplane trips that usually cause motion sickness.

Signs You're Sleep Deprived

by Rachel Swalin

People's needs vary when it comes to sleep. But what if your lack of shut
eye is hurting your health?

Time for bed - You know you're supposed to get seven to nine hours of
sleep a night, but sometimes, you stay up for a night out on the town, to
finish a project at work, or even just to watch Law & Order reruns.

You're always hungry - "If the brain is not getting the energy it needs
from sleep it will often try to get it from food," says Chris Winter, MD,
owner of Charlottesville Neurology and Sleep Medicine in Virginia.

You've gained weight - When you're tired, you don't watch what you're
eating. You may tend to look for all kinds of things to help you feel more
awake, and a lack of sleep can also
have direct effects on your metabolism.

You're more impulsive - People tend to act without thinking when they're
exhausted.

Your memory's shot - "When you're tired, you're usually not paying a
whole lot of attention to what's going on when trying to make a memory.

You're having trouble making decisions - If you've been finding it
harder than usual to manage projects at work and home, lack of sleep could
be the culprit. "Sleep deprivation can affect speed and higher-level
cognitive processing," Baron says.

Your motor skills are off - Yes, tripping over a step might make you a
klutz. But do it a few times in a day and it might just mean you're too
tired to really focus on where you're going. "When you're tired, there's a
lapse in how you neurologically function in general," Dr. Winter says.

Seven foods that fight sun damage

MensFitness Tiffany Gagnon 8/12/2014

Don't Get Burned

The spotlight on sun damage is burning brighter today than ever before. Not
only do we know more about the harmful effects of the sun, but also we have more
information and products available to help fight back. Of course, keeping out of
the sun, covering up exposed skin, and wearing a good sunscreen are your best
bets for protecting yourself against harmful rays, but there is one line of
defense you could be forgetting: your grocery cart.

Sweet Potatoes - Cancer-causing compounds called free radicals are the
enemy when it comes to sun damage. They not only cause damage to skin cells,
but also cells inside the body. One of the best ways to help your body fight
off free radicals is eating
antioxidant-rich foods. A powerful antioxidants
is beta-carotene. Sweet potatoes are packed to the brim with beta-carotene,
so chow down this summer!

Green Tea - Green tea is often applauded for its ability to rev up your
metabolism, but it's also a powerful skin food. Green tea contains a high
concentration of catechins, which boast anti-inflammatory, anti-aging, and
antioxidant effects that fight off free radicals from the sun. It also
contains polyphenols, plant compounds that some studies suggest may be
effective in preventing cancer because they limit the blood supply to
different areas where cancer can develop, explains Carrillo. “Shy away from
bottled, processed teas because the polyphenol count changes once it’s been
on the shelf--it's lower," warns Carrillo. "Brew fresh tea instead.”

Sunflower Seeds - These crunchy little seeds contain the powerful
antioxidant vitamin E. One ounce of hulled
sunflower seeds contains about 10
milligrams, which is about two-thirds of your recommended daily intake.
Sprinkle over salads, mix into oatmeal, or eat by the handful. It's best to
get your dose of vitamin E from whole foods, versus supplements, to reap the
most benefits. Other potent sources include nuts, eggs, green leafy
vegetables, avocados, and whole grains

Tomatoes - Lycopene is another important antioxidant to have in your
diet regularly, especially during the summer. Tomatoes are one of the best
sources. The redder the tomato, the more lycopene it contains. Lycopene is
more easily absorbed by your body when the tomatoes have been cooked, so
reach for tomato paste, juice, soups, and sauces pre-beach day.

Salmon - While antioxidant-rich foods are central to protecting your
skin against the sun, it’s also important to consume healthy fats. Foods
like salmon, tuna, walnuts, and flaxseed are all good sources of
omega-3s
and will help maintain that healthy layer of fat underneath the skin and
prevent skin damage and aging.

Asparagus - Asparagus is another great source of vitamin E! The green
stalks are one of the most effective foods when it comes to neutralizing
cell-damaging free radicals.

Water - Water, water, and more water. The sun dehydrates you, and
dehydrated skin is more sensitive and prone to damage. “Your body is mostly
water, so by staying hydrated, you’re making your skin healthier," explains
Carrillo. "It’s going to prevent loss of moisture, which makes skin wrinkly.
Good hydration is essential.”

Wei's World, January 2015

Mary Elizabeth Dallas, writing for Healthday reported on a British study
showing being bullied as a child may take a larger toll on a young adult's
mental health than being abused or neglected at home.

She wrote, “… Children who were bullied by their peers were about five times
more likely to develop anxiety compared to those who were mistreated by their
parents or other adults. Kids who were bullied were also nearly twice as likely
to self-harm and have more symptoms of depression at 18 as those who had been
mistreated by adults, the study found.”

I read this article with tears in my eyes. I was bullied in junior high
school. Every day after school, the same four older kids would wait for me as I
walked home. They would take turns shoving me, emptying books and papers from my
book bag, taunting me, calling me names, sometimes slapping and punching me, and
just making my walk home from school something I dreaded.

When I went
to high school, I also encountered bullying when I was on the
football team.

I first started getting treated for depression when I was a fellow at the
National Institutes of Health. So… basically I’ve undergone therapy and
medications for almost 40 years. Has my depression been entirely due to
bullying? Probably not since I grew up in a somewhat dysfunctional household and
there was a history of mental illness.

Yet, the bullying still hangs like a malignant spirit in my memory, often
shoving aside the pleasant memories of childhood. At different times I still
feel anger and frustration for no apparent reason. Much of it is directed
against my former tormentors. But much of it is also directed against myself and
even my family members for not having the courage to fight back.

The bullying did have two positive effects. First, it forced me to look
inward and focus my anger and frustration on my studies. Like a magnifying glass
penciling the rays of the sun. Even now, while I’m considered one of the best in
my field, I keep trying to get better because there’s always room for
improvement. Those memories, as disturbing as they are, push me every day.

One other benefit of the earlier bullying is that it has given me resilience.
My inner spirit is stronger. As an adult, I refuse to be bullied by anyone or
anything.